Review by delias29

Have a couple of different brands available for tretinoin sitting on my vanity. Am currently using Retin-A 0.05% but I've used Retacnyl 0.025% & 0.05% before, have only a couple of weeks' use left in my current tube of Retin-A and once that's done, I'll be moving on to Stieva-A 0.05%. These are all creams by the way. Only type I use 'cause only creams are available at my doctor's. I'll update on my thoughts on the Stieva-A later if anyone's interested. I've read many reviews where people say that there isn't much difference between the brands but I have noted some differences.
Retacnyl (by Galderma) comes in bigger tubes (30g), you'll tend to use more. Consistency's thinner than Retin-A and I found that my skin produced a lot more oil while I was on Retacnyl than on Retin-A. Sheets of skin came off while I was on Retacnyl since I tended to use more because of both the consistency and size of the tube. Shedding while on Retin-A is minimal compared to my experience on Retacnyl. But the marked difference is really the oil production.
Retin-A is a great product. I use it for acne. My doctor prescribed doxycycline, sulphur and differin to me when I first started to battle adult acne two years ago. I had asked to be put on tretinoin because a friend recommended I did. However, I used it with little faith.
Back then as my regimen was both doxy (7 months) and RA (12 months), I attributed the success of my acne clearing to the doxycycline and honestly, really didn't think much of the tretinoin except to blame the oily skin on it. I knew it faded the acne macules aka hyper pigmentation. But the mandatory break-in period was a nightmare. Scaly, patchy, flaky skin, cracked when I laughed or ate, redness when the weather got hot or I forgot to sun-protect, raw sores when I accidentally overlapped the tretinoin too close to the sulphur application. O, the pain of acne. Lasted a good 2-3 months? As you can understand, these things attributed to the lack of faith.
Without proper maintenance while on the product, the effects are carcinogenic. So as soon as my prescription ran out (12 months later), my skin by then had cleared to a porcelain-clear complexion, I thought - "yay, time to quit" and I never returned to the doc's for a refill.
Six months since quitting all acne treatment, BAM! Full-blown acne again. This time with a vengeance. Cystic and nodular acne all over the face, two-headed acne pustules etc and especially under the jaw. It started out first as only a few closed comedones on both sides of the cheeks. I was not looking to return to the doc's just yet and thought I could fix it using the acne.org regimen of benzoyl peroxide. Big mistake.
I read somewhere on the internet that benzoyl peroxide works best for young skin, not adult acne. I gave the regimen a good eight weeks of my life and I wish I had done thorough research on it because it really ruined my skin. I found out that because I had been on retin-a previously, my skin had been thinned out and the benzoyl treatment was just too harsh for my skin and damaged it further. For those of you suffering from back-with-a-vengeance acne, and were on some form of tretinoin treatment the first time around, do not go on the benzoyl-peroxide-only treatment. BP is for young skin that can take a harsh beating.
I was looking for answers, and I chanced upon youtube channel: bubblingbolster. If you watch her video diary, you'll get a visual idea of the kind of acne I suffered. I went back to the doctor still thinking that doxycycline will fix me, not tretinoin. And was put on a month's worth of doxy. 4 weeks later, the acne was still not subsiding. Every day I woke up to many active pustules. I was told, give it six weeks. So when I returned for a refill, and inspired by bubblingbolster's recovery, I asked for retin-a again. The doctor actually recommended Roaccutane but I refuse to go on that stuff because even without the oral tretinoin my acne was already making me suicidal and depressed, I didn't want to take something with side effects that would just intensify those feelings.
So 8 months from the last time I used retin-a, I returned to the treatment. Skin-memory kicked in and there was no averse first-time break-in reactions to the retin-a. Minimal peeling or dryness. However, of course there was the purging. This lasted four weeks where places which didn't have acne will erupt. However, I stuck with it. And now I'm in my fifth week and I can tell you, my skin is smooth. Eruptions are still coming, but they'll quickly become macules. Older macules are fading. Most importantly, the cystic and nodular stuff are erupting and flattening. I believe my skin will be better than it was before in a year's time because i've been on this treatment before.
Bottom-line. Do not get off this stuff once you start. Your skin will change its mechanics. The sebum in your skin will be more active and engineer themselves to treat p.acnes bacteria differently than they did before tretinoin re-engineered them and so if you have any inflammation/bacteria, your skin will attack the bacteria and remember that retin-a will do the sloughing off for it and thus not slough off on its own. Even if you stop, like I did and enjoyed clarity for 6 months, before your skin starts to remind you that it needs RA again by breaking out, do not seek other alternative treatments. It's your skin's reminder to you to get back on the RA. Tretinoin is a miracle product and you have to reconcile with the fact that it's a product you use for life. Don't get complacent and quit it.
* 1 & a half year update * Still on tretinoin. Relative clarity, complementing the treatment with clindamycin, tea tree oil for inflammatory acne on cheeks, between brows and chin. No longer have full-blown all-over-my-face acne - just targeted areas. Still seeing the benefits of using this product.